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Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore

Surgical resection of colorectal liver metastases combined with systemic treatment aims to maximize patient survival. However, recurrence rates are very high postsurgery. In order to assess patient prognosis after metastasis resection, we evaluated the main patho‐molecular and immune parameters of a...

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Autores principales: Baldin, Pamela, Van den Eynde, Marc, Mlecnik, Bernhard, Bindea, Gabriela, Beniuga, Gabriela, Carrasco, Javier, Haicheur, Nacilla, Marliot, Florence, Lafontaine, Lucie, Fredriksen, Tessa, Lanthier, Nicolas, Hubert, Catherine, Navez, Benoît, Huyghe, Nicolas, Pagès, Franck, Jouret‐Mourin, Anne, Galon, Jérôme, Komuta, Mina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737782/
https://www.ncbi.nlm.nih.gov/pubmed/32902189
http://dx.doi.org/10.1002/cjp2.178
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author Baldin, Pamela
Van den Eynde, Marc
Mlecnik, Bernhard
Bindea, Gabriela
Beniuga, Gabriela
Carrasco, Javier
Haicheur, Nacilla
Marliot, Florence
Lafontaine, Lucie
Fredriksen, Tessa
Lanthier, Nicolas
Hubert, Catherine
Navez, Benoît
Huyghe, Nicolas
Pagès, Franck
Jouret‐Mourin, Anne
Galon, Jérôme
Komuta, Mina
author_facet Baldin, Pamela
Van den Eynde, Marc
Mlecnik, Bernhard
Bindea, Gabriela
Beniuga, Gabriela
Carrasco, Javier
Haicheur, Nacilla
Marliot, Florence
Lafontaine, Lucie
Fredriksen, Tessa
Lanthier, Nicolas
Hubert, Catherine
Navez, Benoît
Huyghe, Nicolas
Pagès, Franck
Jouret‐Mourin, Anne
Galon, Jérôme
Komuta, Mina
author_sort Baldin, Pamela
collection PubMed
description Surgical resection of colorectal liver metastases combined with systemic treatment aims to maximize patient survival. However, recurrence rates are very high postsurgery. In order to assess patient prognosis after metastasis resection, we evaluated the main patho‐molecular and immune parameters of all surgical specimens. Two hundred twenty‐one patients who underwent, after different preoperative treatment, curative resection of 582 metastases were analyzed. Clinicopathological parameters, RAS tumor mutation, and the consensus Immunoscore (I) were assessed for all patients. Overall survival (OS) and time to relapse (TTR) were estimated using the Kaplan–Meier method and compared by log‐rank tests. Cox proportional hazard models were used for uni‐ and multivariate analysis. Immunoscore and clinicopathological parameters (number of metastases, surgical margin, histopathological growth pattern, and steatohepatitis) were associated with relapse in multivariate analysis. Overall, pathological score (PS) that combines relevant clinicopathological factors for relapse, and I, were prognostic for TTR (2‐year TTR rate PS 0–1: 49.8.% (95% CI: 42.2–58.8) versus PS 2–4: 20.9% (95% CI: 13.4–32.8), hazard ratio (HR) = 2.54 (95% CI: 1.82–3.53), p < 0.0000; and 2‐year TTR rate I 0: 25.7% (95% CI: 16.3–40.5) versus I 3–4: 60% (95% CI: 47.2–76.3), HR = 2.87 (95% CI: 1.73–4.75), p = 0.0000). Immunoscore was also prognostic for OS (HR [I 3–4 versus I 0] = 4.25, 95% CI: 1.95–9.23; p = 0.0001). Immunoscore (HR [I 3–4 versus I 0] = 0.27, 95% CI: 0.12–0.58; p = 0.0009) and RAS mutation (HR [mutated versus WT] = 1.66, 95% CI: 1.06–2.58; p = 0.0265) were significant for OS. In conclusion, PS including relevant clinicopathological parameters and Immunoscore permit stratification of stage IV colorectal cancer patient prognosis in terms of TTR and identify patients with higher risk of recurrence. Immunoscore remains the major prognostic factor for OS.
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spelling pubmed-77377822020-12-18 Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore Baldin, Pamela Van den Eynde, Marc Mlecnik, Bernhard Bindea, Gabriela Beniuga, Gabriela Carrasco, Javier Haicheur, Nacilla Marliot, Florence Lafontaine, Lucie Fredriksen, Tessa Lanthier, Nicolas Hubert, Catherine Navez, Benoît Huyghe, Nicolas Pagès, Franck Jouret‐Mourin, Anne Galon, Jérôme Komuta, Mina J Pathol Clin Res Original Articles Surgical resection of colorectal liver metastases combined with systemic treatment aims to maximize patient survival. However, recurrence rates are very high postsurgery. In order to assess patient prognosis after metastasis resection, we evaluated the main patho‐molecular and immune parameters of all surgical specimens. Two hundred twenty‐one patients who underwent, after different preoperative treatment, curative resection of 582 metastases were analyzed. Clinicopathological parameters, RAS tumor mutation, and the consensus Immunoscore (I) were assessed for all patients. Overall survival (OS) and time to relapse (TTR) were estimated using the Kaplan–Meier method and compared by log‐rank tests. Cox proportional hazard models were used for uni‐ and multivariate analysis. Immunoscore and clinicopathological parameters (number of metastases, surgical margin, histopathological growth pattern, and steatohepatitis) were associated with relapse in multivariate analysis. Overall, pathological score (PS) that combines relevant clinicopathological factors for relapse, and I, were prognostic for TTR (2‐year TTR rate PS 0–1: 49.8.% (95% CI: 42.2–58.8) versus PS 2–4: 20.9% (95% CI: 13.4–32.8), hazard ratio (HR) = 2.54 (95% CI: 1.82–3.53), p < 0.0000; and 2‐year TTR rate I 0: 25.7% (95% CI: 16.3–40.5) versus I 3–4: 60% (95% CI: 47.2–76.3), HR = 2.87 (95% CI: 1.73–4.75), p = 0.0000). Immunoscore was also prognostic for OS (HR [I 3–4 versus I 0] = 4.25, 95% CI: 1.95–9.23; p = 0.0001). Immunoscore (HR [I 3–4 versus I 0] = 0.27, 95% CI: 0.12–0.58; p = 0.0009) and RAS mutation (HR [mutated versus WT] = 1.66, 95% CI: 1.06–2.58; p = 0.0265) were significant for OS. In conclusion, PS including relevant clinicopathological parameters and Immunoscore permit stratification of stage IV colorectal cancer patient prognosis in terms of TTR and identify patients with higher risk of recurrence. Immunoscore remains the major prognostic factor for OS. John Wiley & Sons, Inc. 2020-09-09 /pmc/articles/PMC7737782/ /pubmed/32902189 http://dx.doi.org/10.1002/cjp2.178 Text en © 2020 The Authors. The Journal of Pathology: Clinical Research published by The Pathological Society of Great Britain and Ireland and John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Baldin, Pamela
Van den Eynde, Marc
Mlecnik, Bernhard
Bindea, Gabriela
Beniuga, Gabriela
Carrasco, Javier
Haicheur, Nacilla
Marliot, Florence
Lafontaine, Lucie
Fredriksen, Tessa
Lanthier, Nicolas
Hubert, Catherine
Navez, Benoît
Huyghe, Nicolas
Pagès, Franck
Jouret‐Mourin, Anne
Galon, Jérôme
Komuta, Mina
Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore
title Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore
title_full Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore
title_fullStr Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore
title_full_unstemmed Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore
title_short Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore
title_sort prognostic assessment of resected colorectal liver metastases integrating pathological features, ras mutation and immunoscore
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737782/
https://www.ncbi.nlm.nih.gov/pubmed/32902189
http://dx.doi.org/10.1002/cjp2.178
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